Gaming addiction

Question 1

Mum brings her son in concerned about his excessive gaming, and potentially failing out of his university course. He doesn’t think it’s a problem. Take a history and counsel the son.

Answer 1

Impression
Represents a gaming addiction, where patient appears to lack insight into the problem. Characterised by a persistent pattern of recurrent gaming behaviour for >12 months. Manifested by:
1) impaired control over gaming (onset, frequency, intensity, duration)
2) increasing priority given to gaming such that it takes precedence over other life interests
3) Continuation or escalation of gaming despite negative consequences - leads to impairment of function

Question 2

Gaming addiction - history

Answer 2

History
From patient + collateral from mother
- PC: characterise, duration, nature of functional decline and its severity
- Sx: emotional - irritability, restlessness, isolation from others, lying about amount of time played, loss of interest in other activities
- sx: physical - fatigue, overuse injuries, poor personal hygiene
- Psych screen: depressive, manic, suicidal, psychotic sx
- Past psych
- past medical
- fam hx
- social hx
- substance use
- developmental hx
- forensic

Question 3

Gaming addiction - Examination

Answer 3

Examination

- MSE

Question 4

Gaming addiction - Management

Answer 4

Management
Psychological
- motivational interviewing: assess readiness to change
- Counselling referral, supportive strategies
- Psychotherapies (CBT - goal setting, identification of barriers, development of plans to overcome barriers)

Biological

• treat any other co-morbidities (substance use, depression)
• no evidence for pharmacotherapy in gaming addiction alone

Social
- Family therapy